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Cannabis Supporting Your Practice

Special Series Part Two, Drug Interactions: Cannabis and Analgesics, Sympathomimetics, Liver Enzyme Inhibitors


Dr. Jose Lança is an M.D., Ph.D., and Assistant Professor of Pharmacology in the Faculty of Dentistry, and in the Department of Pharmacology and Toxicology in the Faculty of Medicine at the University of Toronto.

In this interview, PART TWO, we’re talking with Dr. Lança about drug interactions (and implications) that can occur in patients regularly consuming cannabis and/or taking certain prescription medications (part two).

In part three, Dr. Lança delivers important insights on treating patients within the current opioid crisis and provides evidence-based, alternative treatments for pain management.

The implications for dental management when a patient is consuming cannabis and CNS depressants concurrently?

  • Avoiding the adverse effects of over prescribing.
  • Clinical implications of pharmaco-dynamic drug interactions where two or more substances are present and their effect on the CNS, for instance, cannabis and other depressants.
  • Impact of drug interactions where opioids and THC are present.
  • Impact of drug interaction where nitrous oxides and general anesthesia are present.
  • Special considerations: chronically consumed neuroleptics and schizophrenic drugs not prescribed by the dentist.


Special Series Part One, Impairment and Intoxication: Cannabis and Dental Management
Special Series, Part Three: Effective Alternative Treatments to Opioids

Read/download the transcript of the conversation (PDF)

Full conversation (7.07″)

Do dentists have to modify the dose of local anesthetics given to patients who are consuming cannabis regularly?

  • Defining chronic use of cannabis.
  • What type of cannabis use does NOT require a modification to normal dosages?
  • The effect of THC (cannabis) on systemic distribution of lidocaine.
  • THC’s impact on the overall analgesic effect of lidocaine.
  • Special considerations: analgesics and commonly prescribed neuroleptic drugs and reuptake inhibitors.

Read/download the transcript of the conversation (PDF)

Full conversation (7.33″)

Dental management and implications for patients taking sympathomimetics and consuming cannabis

  • Should a patient’s history of myocardial infraction or stroke change the local anesthetic used?
  • How cannabis and sympathomimetics used in conjunction with local anesthetics can cause tachycardia.
  • Special considerations: Common drugs like nasal decongestants and tachycardia. 
  • Treating patients who consume cannabis and have with pre-existing cardio vascular or cerebral history.

Read/download the transcript of the conversation (PDF)

Full conversation (7.31″)

Dental Management for patients taking liver enzyme inhibiting drugs and consuming cannabis

  • Impact on drug concentration in the blood and it’s clinical effect. 
  • Cannabis’s and liver enzyme inhibiting drug interactions and their effects on the patient’s body and level of impairment.
  • What drugs can have an impact on patients regularly taking cannabis.
  • Oral health conditions that can be impacted by drug mixtures.

Read/download the transcript of the conversation (PDF)

Full conversation (6.59″)

We always want to hear your thoughts and questions.

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Until next time!

CDA Oasis Team

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